Dr Bashir Admani
Bedwetting is a common problem in children between five and 12 years old.
Most affected children only require extra attention and a few changes in their bedtime routine to stay dry through the night.
The condition is classified as a clinical problem if the child is unable to keep the bed dry by age seven. It becomes a serious problem when it impacts on self-esteem, behaviour and relationships.
Bedwetting may appear, or increase, when a child is ill. For example, urinary tract infections or certain medicines can cause bedwetting in children and adults. Children with diabetes commonly wet the bed when their blood sugar level becomes erratic. But bedwetting in itself does not mean that a child has diabetes.
Other reasons why a child might wet the bed include small bladders that cannot hold much urine, nervous systems that are not sufficiently developed to get the right signal among the bladder, brain and genetics. Bedwetting appears to run in families.
Recent research suggests that some children who wet the bed may lack sufficient levels of an important hormone, nocturnal arginine vasopressin, which helps decrease the amount of urine produced at night and prevents the bladder from overfilling.
Sometimes bedwetting can be a response to stress or anxiety.
Treatment includes scheduled waking, with parents typically waking up the child periodically at night and walking them to the bathroom to urinate. Limiting the amount of fluids at night may help prevent bedwetting.
Moisture alarms help. When the child urinates in bed, the sensor detects the moisture and immediately sets off the alarm. The child is woken up by the sensation of a full bladder and must finish urinating in the bathroom. Over time, the child starts to recognise the sensation of having a full bladder and learns to wake up automatically to use the bathroom. The alarms cost between Sh4,000 and Sh6,000.
— The writer is a consultant paediatrician at Aga Khan Hospital, Nairobi.
